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Medline ® Abstracts for References 5-7

of 'Suppurative thyroiditis in children and adolescents'

5
TI
Retrospective case review of pyriform sinus fistulae of third branchial arch origin commonly presenting as acute suppurative thyroiditis in children.
AU
Yolmo D, Madana J, Kalaiarasi R, Gopalakrishnan S, Kiruba Shankar M, Krishnapriya S
SO
J Laryngol Otol. 2012 Jul;126(7):737-42. Epub 2012 May 25.
 
OBJECTIVE: Abnormalities of the third branchial arch are less common than those of the second arch and usually present with left thyroid lobe inflammation. This paper describes 15 cases of pyriform sinus fistulae of third branchial arch origin usually presenting as recurrent thyroid abscess on the left side.
METHOD: A retrospective review of 15 cases of third arch fistulae managed 2000 and 2008, diagnosed based on histopathology and radiological evidence of a fistulous tract, and treated with fistulectomy with left hemithyroidectomy.
RESULTS: All patients (six boys and nine girls, aged three to 15 years) presented with recurrent low neck inflammation. Pre-operative ultrasound, computed tomography fistulography and barium swallow demonstrated a third arch fistulous tract, left-sided in all cases. The fistula was detected intra-operatively and pathologically in all cases. Surgery (successful in all cases) emphasised complete recurrent laryngeal nerve and ipsilateral pyriform sinus exposure, to facilitate tract excision, with left hemithyroidectomy. There was no recurrence over three to five years' follow up.
CONCLUSION: Paediatric recurrent low neck inflammatory episodes, due to thyroidal abscess, especially left-sided, should raise suspicion of pyriform sinus fistulae.
AD
Department of Otolaryngology - Head&Neck Surgery, Darjeeling District Hospital, West Bengal, India.
PMID
6
TI
Acute suppurative thyroiditis in pediatric patients.
AU
Rich EJ, Mendelman PM
SO
Pediatr Infect Dis J. 1987;6(10):936.
 
AD
Department of Pediatrics, University of Washington, Seattle.
PMID
7
TI
Acute suppurative thyroiditis in children secondary to pyriform sinus fistula.
AU
Sai Prasad TR, Chong CL, Mani A, Chui CH, Tan CE, Tee WS, Jacobsen AS
SO
Pediatr Surg Int. 2007;23(8):779. Epub 2007 May 30.
 
Acute suppurative thyroiditis (AST), a potential complication of pyriform sinus fistula (PSF), is a rare clinical condition as the thyroid gland is remarkably resistant to infections. Lack of awareness of the entity contributes to the rarity and frustrating recurrences. We performed a retrospective review of all cases of AST due to PSF treated at our institution over a 10-year period. The clinical data, investigations, operative findings and procedures, microbial culture reports and follow-up were recorded and analyzed. Between January 1997 and September 2006, 12 cases (8 males and 4 females) of AST due to PSF were treated. Nine patients (75%) underwent successful complete excision, seven of whom had initial incision and drainage procedures. In three patients (25%) with recurrence, one underwent complete excision at a later procedure, one patient had multiple recurrences with six incision and drainage procedures and two failed attempts of excision of PSF before final successful complete excision. The third patient is awaiting re-excision of the PSF tract. All patients, except the one awaiting re-excision, are well with no further recurrences during the follow-up period that ranged from 18 to 96 months (median, 46.5 months). AST due to PSF is a challenging entity in terms of diagnosis and management as recurrences are common despite meticulous dissection. High index of suspicion and radiological investigations such as barium studies and computed tomography scan aid in the delineation and excision of the fistulous tract.
AD
Department of Paediatric Surgery, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore 229899, Singapore. trsai@rediffmail.com
PMID